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An insurer's perspective on error and loss in pathology

David B Troxel1

  • 1School of Public Health, Health and Medical Sciences, University of California, Berkeley, California, USA. dtroxel@thedoctors.com

Archives of Pathology & Laboratory Medicine
|October 4, 2005
PubMed
Abstract

Insights

Pathology malpractice claims are rare but severe, with melanoma misdiagnosis being the most frequent cause. These errors often involve delayed cancer diagnosis, impacting patient treatment and outcomes.

Area of Science:

  • Surgical Pathology
  • Medical Malpractice Law
  • Diagnostic Errors

Background:

  • Surgical pathology plays a critical role in patient diagnosis and treatment.
  • Malpractice claims can arise from errors in pathology practice, impacting patient care and healthcare systems.

Purpose of the Study:

  • To identify common errors in surgical pathology leading to malpractice claims.
  • To determine the frequency and severity of these claims.
  • To discuss the implications of pathology malpractice claims.

Main Methods:

  • Analysis of 335 pathology malpractice claims reported between 1998 and 2003.
  • Exclusion of nuisance and autopsy-related claims.
  • Categorization and frequency analysis of claim types and diagnostic errors.

Main Results:

  • Pathology malpractice claims are infrequent but carry high severity.
  • Melanoma misdiagnosis and false-negative Papanicolaou tests are particularly severe claim types.
  • Top claim categories include breast specimens, melanoma, Papanicolaou smears, gynecologic specimens, and operational errors.
  • Failure to diagnose cancer accounted for 63% of claims, leading to delayed diagnosis or incorrect treatment.

Conclusions:

  • False-negative melanoma diagnosis is the leading cause of malpractice claims against pathologists.
  • Approximately one-third of misdiagnoses involve melanoma being incorrectly identified as other benign or atypical lesions.
  • Addressing diagnostic errors in melanoma and Papanicolaou testing is crucial for reducing malpractice claims.

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